DMAE (2-dimethylaminoethanol)

DMAE (2-dimethylaminoethanol) is a chemical that has been used to treat a number of conditions affecting the brain and central nervous system. Like other such treatments, it is thought to work by increasing production of the neurotransmitter acetylcholine, although this has not been proven.Requirements/Sources

DMAE is sold in pharmacies and healthfood stores, as well as on the Internet, as a nutritional supplement.Therapeutic Dosages

Manufacturers' recommended dosages and those used in clinical studies vary between 400 and 1,800 mg daily.Therapeutic Uses

More widely marketed today as a memory and mood enhancer, DMAE is said to improve intellectual functioning; however, there are no clinical studies that support its use for these purposes. The basis for such claims probably stems from its purported ability to increase levels of a neurotransmitter called acetylcholine . Drugs and supplements called cholinergics that increase acetylcholine have been used to treat :: Alzheimer's disease , :: tardive dyskinesia , and Huntington's chorea. Because DMAE was believed to be a cholinergic, it has been tried for all of these disorders. However, well-designed :: double-blind, placebo-controlled studies have yielded almost entirely negative results. 3-9 In addition, there is some controversy over whether DMAE really increases acetylcholine at all. 10What Is the Scientific Evidence for DMAE?Attention Deficit Hyperactivity Disorder (ADHD)

There is some evidence that DMAE may be helpful for :: attention deficit hyperactivity disorder (ADHD) , according to studies performed in the 1970s. Two such studies were reported in a review article on DMAE. 11 Fifty children aged 6 to 12 years who had been diagnosed with hyperkinesia (their diagnosis today would likely be ADHD) participated in a :: double-blind study comparing DMAE to placebo. The dose was increased from 300 mg daily to 500 mg daily by the third week, and continued for 10 weeks. Evaluations revealed statistically significant test score improvements in the treatment group compared to the placebo group.

Another double-blind study compared DMAE with both methylphenidate (Ritalin) and placebo in 74 children described as having unspecified "learning disabilities" (also probably what we would call ADHD today). 12 The study found significant test score improvement for both treatment groups over a 10-week period. Positive results were also seen in a small :: open study . 13Alzheimer's Disease

Most people over the age of 40 experience some memory loss, but :: Alzheimer's disease is much more serious, leading to severe mental deterioration (dementia) in the elderly. Microscopic examination shows that in the areas of the brain involved in higher thought processes, nerve cells have died and disappeared, particularly cells that release the chemical acetylcholine. Drugs such as tacrine and danazol, and supplements such as :: huperzine A , are used for Alzheimer's based on their ability to increase acetylcholine levels. Because DMAE is also thought to increase acetylcholine, trials have been performed to test its effectiveness for the same purpose. However, there is no real evidence as yet that it works.

A double-blind, placebo-controlled study involving 27 patients with Alzheimer's disease tested DMAE as a treatment. 14 Thirteen participants were placed in the group receiving DMAE; however, six of them had to drop out of the study because of side effects such as drowsiness, increased confusion, and elevated blood pressure. In those completing the trial, no differences were seen between the treatment group and those taking placebo.

An open trial enrolling 14 patients found no improvement in either memory or cognitive function. The researchers did note improvements in symptoms of depression. But, in the absence of a placebo group, this observation means little. 15Tardive Dyskinesia

:: Tardive dyskinesia (TD) is a potentially permanent side effect of drugs used to control :: schizophrenia . This late-developing (tardy, or tardive) complication consists of annoying, uncontrollable movements (dyskinesias), particularly in the face.

Based on its supposed cholinergic effect, DMAE has been proposed as a treatment for TD. Although some case reports and open studies seem to suggest that DMAE might be useful for this purpose, 16,17 properly designed studies using double-blind methods and placebo control groups have not borne this out. Of 12 double-blind studies reviewed, only one found DMAE to be significantly effective when compared with placebo. 18 A meta-analysis of proposed treatments for TD found DMAE to be no more effective than placebo. 19 It seems likely, though not entirely certain, that the benefits seen in open studies and individual cases were the result of a placebo effect. However, it is also possible that some particular individuals respond well to DMAE, even if most don't.Huntington's Chorea

Huntington's chorea is a genetically inherited disease that results in personality changes and, somewhat similarly to TD, uncontrolled spastic movements. It doesn't usually become symptomatic until a person's age reaches the late thirties or older, although about 10% of people with Huntington's will begin to show signs of the disorder in childhood or adolescence.

DMAE was not found to be an effective treatment for Huntington's chorea in double-blind, placebo-controlled trials, although mixed results have been obtained using DMAE in open trials. 20,21,22Safety Issues

Although most clinical investigations using DMAE report that the participants experienced no side effects, enough researchers have found adverse reactions to suggest that some caution is appropriate in using this supplement. One study, as noted above, reports increased confusion, drowsiness, and elevated blood pressure; 23 another reports headache and muscle tension as possible adverse effects; 24 and another paper suggests that weight loss and insomnia may accompany use of DMAE. 25 There is also one case report of a woman who developed severe TD after taking DMAE for 10 years for a hand tremor. 26 Besides this, a number of manufacturers warn against the use of DMAE by people with epilepsy or a history of convulsions.

Maximum safe dosages for young children, pregnant or nursing women, or people with severe liver or kidney disease have not been established.